卫生部全国细菌耐药监测网2010年华东地区细菌耐药监测

Ministry of Health National Antimicrobial Resistant Investigation Net 2010 report: Bacterial distribution and resistance in east of China

目的总结2010年华东地区18家医院临床分离菌的分布和耐药特征。方法采用纸片扩散法或微量稀释法对2010年华东地区18家医院临床分离菌株进行药敏试验及ESBL的检测,按CLSI 2010年标准判定结果,并用WHO-NET5.4软件进行数据分析。结果 18家医院共分离菌种70282株,其中革兰阴性杆菌49303株,占70.2%;革兰阳性菌20979株,占29.8%。大肠埃希菌和金黄色葡萄球菌分别占革兰阴性杆菌和革兰阳性球菌的首位。金黄色葡萄球菌中MRSA检出率为57.4%;按照CLSI新折点判断,肠杆菌科细菌对碳氢霉烯类的敏感率下降;铜绿假单胞菌和鲍曼不动杆菌对大部分抗菌药物的敏感率均低于70%。肠球菌属对万古霉素和替考拉宁的敏感率在99.3%～94.6%。结论华东地区细菌耐药性问题相对较为严重,尤其是耐药鲍曼不动杆菌等仍呈上升之势。

Objective To investigate the distribution characteristics and drug resistance profile of clinical isolates in east China in 2010. Methods The susceptibility testing of clinical isolates in 18 hospitals from east China was performed using K - B method or automated system. The results were analyzed by WHONETS. 4 according to CLSI 2010. Results Of 70282 clinical isolates, 70.2% was gramnegative bacill and 29.8 % was gram - positive cocci. E. coli was the most frequently isolated pathogen in gram- negative bacilli. Staphylococcus aureus was the most common pathogen in gram - positive cocci. 57.4% of Staphylococcus au- reus was MRSA. The susceptibility rates of P. aeruginosa and Acinetbacter spp. to the most of antimicrobial agents tested were less than 70%. Some vancomycin resistant E.faecium and E.faecalis strains were detected. Conclusion Antimicrobial resistance of clinical bacterial isolates in 2010 is still increasing in east China, especially resistant A. baumannii. A scientific surveillance system on antimicrobial resistance with accurate data is urgently needed for the rational use of antimicrobial agents and the control of bacterial resistance.